Medicaid Cuts?

Some conservative Republican Senators are looking to cut Federal transfers to the States earmarked for those States’ Medicaid programs.  Others are concerned.

[T]he [conservative Senate Republicans’] Medicaid plan could affect many more people and shift significant costs onto hospitals and states.

Going Soft

Senate pseudo-Republicans are balking at one good item that was contained the House-passed American Health Care Act: repeal of Obamacare’s trillion dollars’ worth of taxes.  These guys actually don’t see the value of that repeal.  Senator Susan Collins (R, ME) is typical:

I don’t see how you can repeal all of the pay-fors…and still meet the goal of providing health-insurance coverage for people who truly need assistance[.]

Aside from the false premise of needing Federal government “pay-fors” as a default position, rather than a last result, the Lady from Maine and her fellows plainly either don’t understand free market principles, or they have no confidence in free markets.

Foolishness

James Capretta and Lanhee Chen of American Enterprise Institute and the Hoover Institution, respectively, have a piece in a recent Wall Street Journal edition that talks about how to “nudge” uninsured Americans into getting health coverage plans.  It’s impressive in its…foolishness…(I’m being polite).

Congress can help these Americans and many others get insurance by enrolling them in no-premium, no-obligation plans from which they could withdraw if they wanted to.

No. Not only no, Hell no. No squared. We’ve enough Big Government intruding into our private lives, arrogantly presuming to make our private decisions for us, without adding this to the steaming pile.

Obamacare

As The Wall Street Journal rightly pointed out, regarding the failed Obamacare repeal and replacement effort and the failing renewed discussions between the House Republican Conference and the Freedom Caucus of No,

The fury…suggests that some Freedom Caucus opposition is more cynical than sincere. Do its members want to appear to negotiate in good faith but insist on changes that centrists can’t accept, so they can then accuse centrists of killing the reform revival?

And

…perhaps there’s still hope for health-care reform. But first Republicans have to decide if they can accept progress that is short of perfection. If they can’t, then they’ll blow their best, and maybe only, shot at repealing and replacing a failing entitlement.

Continued Veterans Administration Failure

Dr Dale Klein is, formally, on the Veterans Administration payroll—to the tune of a $250,000/yr salary—but he’s not employed by them, and so his pain management skills are actively denied our veterans who would benefit from them.  Klein blew the whistle on his proximate employer’s—Southeast Missouri John J Pershing VA facility—secret waiting lists and wait time manipulation practices.  Now he’s shunned by his employers and banished to a room by himself where he’s denied access to his patients and patients are denied access to him.

House Freedom Caucus of No

Yesterday, the membership of the House Freedom Caucus of No forced the American Health Care Act, the first stage of a three-stage Obamacare repeal and replace program offered by the majority of the House Republican Conference, to be withdrawn from the day’s backup vote (recall that these No-ers already had forced a delay from Thursday’s vote over their demand to have their way or there could be no Act), and so there will be no AHCA.

Delays

The House Republicans were forced to cancel yesterday’s scheduled American Health Care Act vote.  The Freedom Caucus, the Caucus of No, couldn’t be satisfied.  Congressmen like Jim Jordan (R, OH) and Caucus of No Chairman Mark Meadows (R, NC) refused late compromises, all the while insisting by implication from their refusals that constituents of other Congressmen, for instance Tom Cole (R, OK), worked for them and not that Cole worked for his Oklahoma constituents—and that those Oklahoma constituents might have different imperatives than those Congressmen of the Caucus.  So, no compromise from the No-ers.

Obamacare Replacement

One aspect of the plan on offer in the House is this:

…whether it includes enough reform to arrest the current death spiral in the individual insurance market.

Notably, the bill includes a new 10-year $100 billion “stability fund” that allows states to start to repair their individual insurance markets. Before ObamaCare, it wasn’t inevitable that costs would increase by 25% on average this year, or that nearly a third of US counties would become single-insurer monopolies. With better policy choices, states can make coverage cheaper and more attractive for consumers and coax insurers back into the market, and the stability fund is a powerful tool.

Republican Gadflies

Karl Rove talked about health care coverage prospects in a recent Wall Street Journal op-ed, and that triggered a thought in my pea brain.

Senator Tom Cotton (R, AR) has announced that the House plan on offer, a plan designed to be passable through reconciliation, with later phases of repeal and replace for completing the task, is dead on arrival, and the House shoe start over and produce a more comprehensive plan in this first phase.  But Cotton has chosen to not offer a plan of his own, or outline what a plan acceptable to him would look like other than to address taxes and to more fully repeal right damn now Obamacare, or even to offer the tactics he’d use to get the new plan—which could not be done through reconciliation—past a Progressive-Democrat filibuster.

Tax Credits in the Obamacare Replacement Proposal

In the main, I’m opposed to these on a couple of grounds.  One is that it’s just more welfare; we need to find a way to move folks off welfare and into the labor force and jobs rather than keeping them trapped in the welfare cage—like we did when we originally reformed the food stamps program by requiring recipients to get a job or lose the stamps.  That reform not only reduced overall unemployment, it put recipients back into jobs (and off that welfare program).  These weren’t make-work jobs, either; net prosperity for those recipient families increased.  (Then the Obama administration withdrew the work requirement, and we got record numbers of folks back on food stamps).